The state of me….

This is as much as a anything a status report I’m writing to my future self, so the rest of you are welcome to go look at kitten pictures or something if you want and come back later…

One of the reasons I decided to jump from Palm/HP and do something else was that I realized I had to put myself in a situation where I could focus more energy on my weight, because I was already pushing the risk factors for my weight and age a lot further than I should be comfortable doing. I’ve been fairly lucky so far that I’ve stayed pretty healthy; I really shouldn’t pretend that luck is going to continue. The stress and challenges of that environment made it difficult. That’s one reason I didn’t stay in the mobile sector when I shifted — it was hard to see it getting less stressful no matter which company/vendor/platform I went with.

So that was run factor — but not by any means a primary factor — of my decisions. And that part has worked out pretty well so far. I work with fun people, it’s a good product, a well-run company, and I’m enjoying what I do. And while I won’t say it’s stress free (nor would I be happy if it was.. I know myself too well) I don’t wake up in the middle of the night feeling like I’ve fallen into a Fellini film. Or a Kafka novel. There’s something rather nice about the change.

If there’s one thing I find less interesting to read on a blog than someone talking about how they intend to lose weight, it’s someone whining about how hard it is to lose weight (and therefore, why you should feel bad about it that they haven’t). Double down on that when I’m doing the whining. So I decided not to (you can thank my by buying something from Amazon, and using their affiliate money I’ll buy salty fatty snacks to chew on while blogging for your amusement…)

The most powerful tool I’ve found for getting a handle on weight loss is the food diary. Simply put, you write down everything you eat, and when you eat it. You track portion size so you know how much you’re eating, and you calculate how many calories you eat from it. And in theory, if you eat fewer calories, you’ll lose weight.

What we’re finding out is that it’s not that simple. There’s a new study out of U North Carolina where they studied zebrafish and found that different gut bacteria populations make it easier or harder for the animal to absorb dietary fat. There’s been a lot of discussion in the last few years about whether the flora and fauna in your digestive tract might encourage obesity, but this is the first study I’ve seen that directly shows it happening. These bacteria (known as Firmicutes) also seem to prosper when you eat a high fat diet. If these findings are confirmed, it’d be proof that “a calorie is a calorie” is false, and in fact, exactly what a calorie is may have to be completely redefined.

Why? Because one aspect of digestion is that it takes energy to digest food and produce energy. Our concept of calories has long made at least broad assumptions that this amount is constant — carbs take this amount to digest, fats that digest. This study kills that, because if you happen to be populated with bacteria that make it easier to absorb the energy in foods, then the net calories you get will be higher than expected. If your body is populated with gut bacteria that don’t help digestion, then the calories you get from the food will be lower than expected. This will all vary for every person, because all of our gut populations are unique, and that seems to show the whole idea of “counting calories” except within somewhat broad ranges to be headed towards obsolete. Life is more complicated than that.

In talking to my doctor about all of this, he pointed me at another study (I don’t have a link to it, unfortunately) where they found that after a weight loss that’s followed by a weight gain, losing that weight again is significantly more difficult. Those many of you who’ve run into this, feel some comfort that it’s not psychological. It’s (evidently) leptin. Leptin is a hormone that the body uses to regular fat depositing into fat cells as well as overall metabolism. This study found that after a significant weight loss and a weight gain, leptin levels in the body were suppressed, leading to a lower metabolism. A lower metabolism implies the body spends fewer calories to get its job done, meaning more calories are available to rebuild the fat stores. Worse, it can take six or seven years for Leptin to return to it’s normal levels. Assuming these studies are confirmed as research continues, this strongly implies that bodies are set up to return to a weight level it previously had, and it’ll adjust it’s metabolism to return to that previous weight level. Taking that 20 pounds off a second time is really harder to do than it was the first time. Which ties into the concept of a body having a “set point”, a body weight it’s decided it wants to maintain, even if you don’t. Set point is still controversial in some corners, but seems to be getting growing acceptance in diet research. If you want some background on all of this, try here and here.

That’s all kind of the geeky background leading up to this blog piece, and some of the stuff I’ve been working on the last few months. In February, I hit 410, and that was heavy enough that I decided to draw the proverbial line in the sand. I sat down and analyzed my diet (about 3000 calories a day), figured out what changes I needed to make to get myself into a moderate losing cycle, and then started following that diet. My target range was (and is) in the 2200-2400 calorie range.

I mentioned food diaries at the start of this piece. They are a “killer app” when trying to figure out how to manage your weight, because they force you to understand what you eat and when you eat it, and they also force you to get a better understanding of portion sizes. Here in the US today, our concept of a portion size has mutated beyond any rational understanding, thanks in large part to a restaurant culture where we’ve been trained huge portions are a good thing. I’m not even talking about the fast food “super size” concept, which makes it even worse. For many of us (I’m not immune) there are a lot of unconscious calories that get ingested, where if you’re asked, you don’t even remember eating them, or you don’t realize just how many calories you ate (and most of us severely underestimate calorie counts).

In my case, I’ve done this long enough to have a good sense of what I’m eating. When I did my sanity check diaries, I found informal estimates to be within 10% of the actual counts, which in my mind is good enough for this kind of thing. If they’d been less accurate, I’d have done formal diaries until I was consistently accurate. If you’re new to all of this, don’t guess. Do diaries and follow the process and write it all down. These days, I’m using “Lose it!” and their iPhone app, since it makes it convenient, but I also really like the Livestrong site.

Both of those sites will give you general guidance on what your calorie range should be if you want to lose weight. When I checked mine, here’s what one of the sites tell me:

In theory, I should be able to eat 3,000 calories a day, lose weight, and hit 200 pounds in about 2.5 years.

The reality: I’ve been eating 2,400 a day since February, and I’ve lost 12 pounds. That’s more like 1.5 pounds a month, not a week.

I point this out not to criticize these sites, but to point out individual situations are just that: individual. The only criticism I have is that these sites don’t make it clear enough that these suggestions are generalizations — and that’s a challenge throughout the health/diet/nutrition industry and literature. Too many things are taken as “this is the value, this is the truth” when in fact those things vary widely depending on the situation.

My situation is heavily affected by my diabetes, by my previous weight loss, and god knows what other factors. But in my situation, my metabolism is inhibited, even though I have normal thyroid levels — the typical easy test for thyroid, and the one many doctors use as the only test. (by the by, this site suggests that if I want to maintain my weight, I can do it at around 3,800 calories a day. Imagine what might happen if I actually ate to that level.

I’m lucky that I have a really good doctor who’s involved in all of this, and has been endlessly useful with advice and perspective on the complexities involved. For all the diet industry and many of the pundits want to make this simple (“eat fewer calories, lose weight” is about as relevant and accurate as “just say no” was), if you think about it, if it really was that simple, would so many people be struggling with actually pulling it off and getting the weight off?

In my case, I’ve been eating about a thousand calories a day less than what the sites say is my maintenance range for eating, and I’ve been doing it for six months. And this is the result:

It trends down, it trends back up. Overall, there’s that slight downward trend, but if you looked at that data without knowing what it was about, I think “whatever you’re working on, it’s fighting back” is not an unreasonable interpretation. And then all of a sudden, as if it gave up the fight, you see the drop happen. (data geek note: to minimize some of the noise in the data, I’m using 7 day running averages to smooth it out. In reality, I find my weight bounces within a two pound range and that can make it tough to see the more general trends…)

And so far, it seems to be continuing, although the head cold I got on jury duty is complicating understanding what’s happening. (achoo).

Will it continue? We won’t know until it plateaus, I guess. I’m hoping so. But think about it in the context of how most people think about and deal with weight loss. You’re told “cut calories, and you’ll lose weight”. So you cut calories, and nothing happens much for the first couple of weeks. And you get frustrated, and you quit.

Not many folks are going to keep it up six months waiting for results. And very little of the literature gives them any indication that might be needed. Most it’s “if you don’t lose weight, you’re being lazy”…

To put this all in larger context, here’s a longer timeframe taken at monthly intervals.

Can you guess when my body flipped the lever and went diabetic? My best guess is right around the time of that first dot, where you can see that initial weight loss. That was also about the time my dad got sick and then died — I ate my way through most of 2008 (I am a classic stress eater. if it wasn’t painfully obvious).

For what it’s worth — and yes, I’m treating this the way a geek treats and engineering challenge, because it is — I keep a spreadsheet where I log every day my weight and every glucose test I take, as well as blood pressure every few weeks to make sure it’s staying under control, and any medication changes, and any unusual symptoms or off feelings. And then I also do a monthly spreadsheet with the weight on the last day of the month and whatever notable things happened that month. It makes for a quick way to see if a change helped or hindered, or what events happened when. And a while back I dug through all my notes, old blog posts, usenet postings, anything I could find, and tracked down every mention of my weight I could find, so I have some data going all the way back too high school, since I wrestled in and around 145 as a sophomore). There are definite gaps,w here I stopped paying attention for a while, but I’ve found turning this into a daily and monthly ritual was a very useful way to make myself conscious of this data and the trends, and so I can’t exactly not pay attention to it, especially when the arrows are pointing in the wrong direction. (on the other hand, it’s possible to get way too anal about minor changes that don’t matter; hence the seven day rolling averages to factor out day to day variations. half a pound from monday and tuesday is meaningless, unless it’s part of a longer trend. But by tracking this stuff every day, you never give yourself a chance to not be aware of that trend).

That first weight loss in the chart ends the month dad went in the hospital. And the weight gain stops the month we closed out the work with the lawyer on the estate. I’m not kidding when I say I ate my way through that entire shebang. The data starts in December of 2007. I know (in retrospect) by March of 2008 I was showing significant symptoms of being diabetic, and gaining weight despite being what I now see as undiagnosed diabetes. My previous glucose was in march 2007 and normal, so the lever flipped sometime after that, either in Q3 or Q4 2007. I normally would have done a glucose test in early 2008, but, well, there were other priorities (so it goes). And then you can see how the weight loss kicks in again, and then accelerates.

That’s one sick body falling apart. And I finally realized it and called the doctor and said “we should take some tests”. The last straw was when I went to do some weeding in the yard, and had to stop after 15 minutes, because I was totally worn out. And something clicked in the back of my head and said “something is really wrong here”. The tests came back; my glucose was over 400. My triglycerides were around 600. You could, as I so humorously put it, make popsicles from my urine. I don’t recommend that, by the way. It’s not unrealistic to think I was way too close to a diabetic coma or some other kind of attack.

That was three years ago today.

Do I wish I’d kept that weight off? Yes. Did I have an ability to? It’s unclear, given how things have gone taking it off again these last few months. Maybe. But there was a lot to learn about how to be diabetic and how to live as one, and a very sick body that needed time to heal.

I’m a believer in looking back for understanding, but looking forward to opportunity. What is, is. Wishing changes to the past doesn’t change it.

So look at where you’ve been, to help map out where you should go. I’m going to continue pushing the calorie count I’ve been pushing, the one that says I could be closer to 7-8 pounds a month instead of the two I’ve averaged, and see how it goes. I’ve found I can drop that to about 2,200, but if I drop below that the blood sugars go wonky. My doctor and I have talked about adjusting the diabetes drugs for that, but I haven’t wanted to get into that kind of active adjustment/management prior to taking my vacation, which has been on hold for reasons that I haven’t talked about (keeps hoping this will all break free soon….).

I’m a couple of weeks into the “new!improved!now with cortisone!” knees and have been testing them out, in and around this stupid head cold (achoo), and they’re reacting great. Last weekend was my first unpaved trail, uneven territory traipsing, and they came out of it with gold stars. The broken little toe (kicked a door. ouch) not so, or I’d be ramping up the exercise a bit more aggressively. Well, I would, if it weren’t for the head cold. But the toe needs another week.

Remember when they told you all you need to do is exercise more and eat less?

Oh, god, I wish it was that simple…

But honestly? It never is…

But my bottom line is this: 12 pounds, or 6% of the weight I want to remove. Whether it came off fast or slow, easy or hard, it’s off, and it’s not coming back if I have any say in the matter. I’m having to buy clothes one size smaller, which is awesome, and I have a bunch of clothes that no longer fit, which is awesome.

And now, it’s just trying to take off the next pound, the next five, the next twelve. What works for me, it seems, is the long slow grind. And so we grind away…

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